[Excerpt] In this book I follow workers' union organizing efforts at Santa Rosa Memorial Hospital between 2004 and 2010. In 2004 and 2005, workers and union leaders attempted to organize within the standard framework of the federal National Labor Relations Board (NLRB). Yet in the face of a concerted and sophisticated antiunion campaign led by management and supported by the hospital's religious leadership, workers and union leaders were forced to withdraw from this election in the face of imminent defeat. The campaign then became more open-ended as the union sought what it termed a "fair election agreement," a set of ground rules and accountability mechanisms that would limit the hospital's antiunion practices. In this effort workers and union leaders organized in the political and religious communities in new ways. Between 2007 and 2008, the union built a community coalition that sought to link the Memorial campaign with the county's broader healthcare crisis. Although the coalition was unsuccessful in its narrower political goals, it was an important part of the union's broader project. Between 2005 and 2009, the union built a powerful religious and political coalition to highlight the contradictions between the values the hospital asserted and its antiunion practices, a project that did win important concessions from the hospital corporation in the fall of 2008. At the very moment of greatest hope, however, the union was thrown into disarray by an internecine labor dispute. When workers finally voted on unionization in December 2010, they did so with few resources and in opposition to the Service Employees International Union (SEIU), the organization that had helped to initiate the campaign.
Throughout this book, I argue that for unions to remain relevant in the hospital industry and beyond—winning support among workers, winning campaigns against employers, and winning broad-based political power— they must recognize the cultural dimension of labor struggle, and must be concerned as much with putting forward a vision of the public good as with winning material advantage. The campaign at Santa Rosa Memorial Hospital—and its relationship to broader successes and failures in the labor movement—illustrates the possibilities and perils of this approach to labor struggle.